Healthcare Provider Details

I. General information

NPI: 1376760652
Provider Name (Legal Business Name): ROBERT PICK LMHP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13603 FLANAGAN BLVD YOUTH CARE BUILDING
BOYS TOWN NE
68010-7501
US

IV. Provider business mailing address

13603 FLANAGAN BLVD YOUTH CARE BUILDING
BOYS TOWN NE
68010-7501
US

V. Phone/Fax

Practice location:
  • Phone: 402-498-3358
  • Fax: 402-498-3333
Mailing address:
  • Phone: 402-498-3358
  • Fax: 402-498-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1544
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: